Senior Workers' Compensation Claims Adjuster

MDD Forensic Accountants

Senior Workers' Compensation Claims Adjuster at Davies North America responsible for investigating and managing claims. Requires active adjuster license and 5-7 years of relevant experience.

Posted 6/15/2026full-timeNew Mexico • New Mexico • 🇺🇸 United StatesSenior💰 $85,000 - $92,000 per yearWebsite

About the role

Key responsibilities & impact

Investigate and evaluate claims to determine coverage, compensability, and liability
Conduct thorough investigations, including interviews with claimants, employers, and witnesses
Obtain and review relevant documentation (e.g., medical records, police reports, employment records)
Develop and implement strategic action plans for claim resolution
Prepare and present clear, accurate, and timely reports to clients and carriers
Manage EDI reporting and CMS/Section 111 compliance requirements
Negotiate settlements with claimants and legal representatives to achieve fair resolutions
Oversee litigation activities, ensuring effective cost control and alignment with account requirements
Utilize approved vendor partners to support claims handling activities
Handle complex claims, including catastrophic losses and sensitive issues
Respond promptly and professionally to client inquiries and communications
Maintain compliance with all licensing and regulatory requirements
Stay current with industry trends, legal updates, and best practices through ongoing training
Support team development by mentoring and sharing expertise with colleagues, as needed
Perform other duties as assigned

Requirements

What you’ll need

Active New Mexico Adjuster License (required)
5–7 years of experience handling workers’ compensation claims, including complex files
Bachelor’s degree or equivalent combination of education and professional experience
Proven experience handling litigation and complex claim scenarios preferred
Strong understanding of workers’ compensation claims handling principles and practices
Knowledge of medical terminology and legal concepts, including litigation management
Ability to conduct detailed investigations in multi-party environments
Excellent analytical and problem-solving skills with strong attention to detail
Ability to manage multiple priorities and meet time-sensitive deadlines
Proficiency with claims management systems and standard business software
Strong written and verbal communication skills, including report writing and presentations
Ability to maintain confidentiality and exercise sound judgment
Ability to quickly learn and adapt to evolving processes, regulations, and technology
Working knowledge of multi-state laws and regulations is a plus
Ability to work both independently and collaboratively in a hybrid work environment

Benefits

Comp & perks

Medical, dental, and vision plans to support your health and that of your family
A 401(k) plan with employer matching
Time‑off policies, including Discretionary Time Off (DTO) for exempt employees and Paid Time Off (PTO) for non‑exempt employees
Paid holidays
Life insurance and short‑term and long‑term disability coverage

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

workers' compensation claims handlinglitigation managementinvestigative techniquesclaims management systemsmedical terminologylegal conceptsanalytical skillsproblem-solving skillsreport writingmulti-state laws and regulations

Soft Skills

attention to detailtime managementcommunication skillsconfidentialityjudgmentadaptabilitycollaborationmentoringnegotiationstrategic planning

Certifications

New Mexico Adjuster License